What's happening
This bill requires insurance policies in New York to cover opioid medications without prior authorization and at equal rates.
Why it matters
Removes administrative barriers. By banning prior authorization for opioid prescriptions, the bill makes it quicker and easier for patients to obtain necessary pain management, potentially reducing delays in treatment for acute or chronic pain.
Ensures cost equity among opioid medications. The requirement that all opioid medications be covered at the same rate means insurers cannot make some opioids more expensive than others, which could influence prescribing decisions or limit patient access to certain drugs.
Strengthens prescribing authority. The bill respects the judgment of authorized prescribers by mandating continuous coverage for the full duration of a legitimate prescription, reducing potential interference from insurance companies.
May impact opioid use patterns and oversight. While improving access for those with medical need, this policy could raise concerns about the ease of obtaining opioids and the role of insurance in monitoring potential misuse or overprescription.
Albany, before your first meeting.
Every bill that moved yesterday, summarized in a sentence and ranked by impact. The Albany Scorecard follows on Sundays.
Free. Unsubscribe in one click. Want alerts on specific bills? Create an account.
Who cares
Headline styles
Require Insurance for Opioids
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to insurance
- Referred to insurance
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
8710
2017-2018 Regular Sessions
IN ASSEMBLY
October 5, 2017
Introduced by M. of A. ROSENTHAL -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to insurance coverage of opioid medications
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 34 to read as follows:
(34)(A) Every policy that provides medical, major medical or similar comprehensive-type coverage, or coverage for prescription drugs must provide coverage of opioid medications and prescription drugs. Such coverage shall continue to be provided during the entire period of time the medications and drugs are prescribed or administered by an authorized prescriber or administrator. Such coverage shall not require prior authorization from the insurance company prior to administration or prescription of such medications and prescription drugs. Such coverage shall be at the same rate regardless of the opioid medications being administered or prescribed. An insurance company shall not charge a different rate for any medication in the opioid class.
(B) Coverage provided under this paragraph may be subject to annual deductibles and co-insurance as deemed appropriate by the superintendent.
§ 2. Subsection (l) of section 3221 of the insurance law is amended by adding a new paragraph 20 to read as follows:
(20) (A) Every policy that provides medical, major medical or similar comprehensive-type coverage, or coverage for prescription drugs must provide coverage of opioid medications and prescription drugs. Such coverage shall continue to be provided during the entire period of time the medications and drugs are prescribed or administered by an authorized prescriber or administrator. Such coverage shall not require prior authorization from the insurance company prior to administration or
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD13544-01-7
A. 8710 2
prescription of such medications and prescription drugs. Such coverage shall be at the same rate regardless of the opioid medications being administered or prescribed. An insurance company shall not charge a different rate for any medication in the opioid class.
(B) Coverage provided under this paragraph may be subject to annual deductibles and co-insurance as deemed appropriate by the superintendent.
§ 3. Section 4303 of the insurance law is amended by adding a new subsection (l-3) to read as follows:
(l-3) (1) Every policy that provides medical, major medical or similar comprehensive-type coverage, or coverage for prescription drugs must provide coverage of opioid medications and prescription drugs. Such coverage shall continue to be provided during the entire period of time the medications and drugs are prescribed or administered by an authorized prescriber or administrator. Such coverage shall not require prior authorization from the insurance company prior to administration or prescription of such medications and prescription drugs. Such coverage shall be at the same rate regardless of the opioid medications being administered or prescribed. An insurance company shall not charge a different rate for any medication in the opioid class.
(2) Coverage provided under this paragraph may be subject to annual deductibles and co-insurance as deemed appropriate by the superintendent.
§ 4. This act shall take effect immediately.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.